Why are you interested in digital technologies and mental health? Special interview
Interview with Bob Gann, author of Digital Inclusion in Health and Care in Wales
Why are you interested in digital technologies and mental health?
I’ve been interested for a long time in how digital can enable people to take a more active role in their own care and take more control of their own lives. I set up the first national NHS website in England as long ago as 1999, and I was strategy director for www.nhs.uk for several years. Last year I was very pleased to carry out the research for the Wales Co-operative Centre report on Digital Inclusion in Health and Care in Wales.
On a personal level, like everybody I have friends and family who have experienced mental health issues. In particular, my kid brother took his life six years ago after a period as an inpatient in a mental health unit.
In your research what has emerged to suggest that digital technologies can support people’s mental health?
There’s good evidence that digital health tools can be very effective in supporting people with mental health issues. NICE Guidelines show that therapies such as online cognitive behaviour therapy (CBT) can achieve comparable outcomes to face-to-face therapy. Delivering the same therapy content in an online format improves access to psychological therapies (there are often waiting lists for face-to-face therapies, while in Wales there may be particular difficulties in travelling to appointments). Many people prefer to access therapy in this way, in their own time and in their own home.
It’s possible that those who’d benefit most from digital technology to support their mental health are the least likely to be online. What approach would you suggest to address this?
Mental health issues often go hand in hand with social problems including low income, unemployment, homelessness, and social isolation. People experiencing these forms of social disadvantage are much less likely to be online than the rest of the population. So we have a “digital inverse care law” in today’s society where the people who could most benefit from digital health tools and services are the least likely to be online.
When I was compiling my report on Digital Inclusion in Health and Care in Wales, I came across great practical examples of how we can address this digital divide and support people with mental health issues to make the most of digital technologies.
I saw how Digital Communities Wales has worked with partners (including Mind, Mental Health Matters Wales, Ponthafren Association and Merthyr Tydfil Housing) to provide access to digital technologies and support for digital skills and confidence for people with mental health issues. Digital Communities Wales supported Mental Health Matters Wales by providing kit that it can use with its service users, in community settings. DCW provided MHMW with a laptop, iPad, wireless keyboard and Bluetooth speakers. Service users now go online for shopping, general searching, registering for courses, NHS information and dealing with referrals to other agencies.
Vale of Clwyd Mind has trained volunteers to be digital champions. Caerphilly based mental health charity Gofal has signed the Digital Inclusion Charter and worked with Digital Communities Wales to provide training to staff, showing them how to support people to get online.
How can health service providers keep up to date with the digital tools available for mental health?
There are so many mental health digital tools and apps available. There are over 300,000 health apps for Apple and Android. The World Health Organization has estimated that 30% of all health apps are for mental health – so that’s something like 100,000. How can health professionals, let alone patients and service users, keep up to date and sift the good ones from the bad?
The NHS in England has been developing an NHS Apps Library of quality assured digital tools and apps. All the apps published on the library have passed through an assessment process designed by expert reviewers to ensure they are safe, secure and work effectively. The NHS Apps Library currently includes 17 mental health apps, although new apps are being added regularly.
The NHS is now working with an independent organisation, ORCHA, who have developed their own apps library. The ORCHA apps library has many more mental health apps so check that too.
Are you aware of any particular apps, websites or devices that can help people with their mental health and wellbeing?
The NHS Apps Library includes some of the better known digital mental health tools, such as Big White Wall, Silver Cloud and IESO. Some of these may not be available in all parts of the country. The Silver Cloud online CBT platform is currently being rolled out in Wales.
People in my family are keen on diary based apps such as Moodpath and Drink Less which help you to keep track of moods and what might be influencing them.
In my work, I’m a big fan of the Mental Elf which keeps me up to date with the latest research and best evidence on mental health. Periodically Mental Elf host a Mental Health Jukebox to which people can contribute suggestions for music which they’ve found helpful, consoling or inspiring. Suggestions are curated into an hour long playlist. As a music aficionado I’m pleased that several of my suggestions have made the cut. I haven’t seen it recently though.
Finally, if you had the resources to develop one piece of digital technology to support people’s mental health, what would it be, and why?
If we could do one thing I’d like to see digital technology brought to bear on preventing the tragedy and awful waste of suicide. In Merseyside, the Zero Suicide Alliance is developing a digital suicide prevention resource, capturing best practice and learning from across the UK and abroad (including Stanford University in USA). This work is doing clever things with the use of data analytics to predict suicide risk from the language people use in their digital communications – emails, social media, even phone calls – and spot potential dangers (of course with the person’s consent). Suicide is preventable and it’s exciting to see what digital could do to reduce the risk.